1. When planning to record or broadcast a cardiothoracic surgery operation, an operating surgeon must prioritize the safety, needs, and rights of the potential patient-subject:
     
    1. The operating surgeon must directly obtain the patient’s informed consent for participating as a subject in a live or taped broadcast, separate from the consent for the actual operation, including use in video rebroadcast.
       
    2. The operating surgeon must disclose to the patient the composition and the size of the potential audience.
       
    3. The operating surgeon and moderator may receive remuneration for associated educational efforts but not directly for participation in live surgery. Surgical compensation can only be provided consistent with national payment policies. The operating surgeon and moderators must comply with the STS Standards for Interactions with Companies.
       
    4. The operating surgeon and associated surgical team must take all necessary steps to protect the patient-subject’s privacy and to ensure confidentiality of all medical information.
       
  2. Prior to planning to broadcast an operation live, the surgeon should justify to an appointed entity that the live approach has significant educational advantages over a recorded video. The appointed entity should include at least one member of the STS Standards & Ethics Committee.
     
  3. Cardiothoracic surgeons should not participate in live surgery broadcasts to the public or lay audiences using any medium, including television or the internet (inclusive of social media).
     
  4. Live surgery broadcasts to audiences of surgical professionals become progressively less acceptable with more rigid scheduling constraints, increasing complexity of the operation, decreasing educational value of the procedure, greater intensity of the surgeon’s interaction with the audience, and less familiarity of the surgeon with the operating room environment. On these grounds, live surgery broadcasts of surgical procedures by STS members are subject to the following conditions: 
     

    1. Cardiothoracic surgeons performing live surgery must be recognized experts in the specific procedure, demonstrate to the appointed entity that they have substantial experience performing live surgery and/or be supervised by a collaborator highly experienced in live surgery broadcasts.
       

    2. Cardiothoracic surgeons should not participate in live surgery broadcasts when rigid broadcast schedules constrain the operation’s starting time or duration, or when a specific predetermined operation must be fit into a specific timeframe.
       

    3. Operations of greater educational value to the surgeons in the audience, relative to their clinical needs, should be chosen over operations of lesser educational value. Operations are inappropriate for live broadcast if intended to show that an operation can be done rather than to demonstrate to others how to do it.
       

    4. Cardiothoracic surgeons should not participate in broadcasts of operations that promote aggrandizement of the surgeon or of the surgeon’s operating facility or institution, or carry a risk of implied endorsement of any commercial products.  Off-label use of any product is highly discouraged in live surgery broadcasts.
       

    5. Industry representatives should not be visible in any actual broadcast surgical procedure, and any involvement should be limited to addressing technical guidance as needed.
       

    6. The operating surgeon should be thoroughly familiar with and experienced in the procedure being broadcast and with the specific medical devices and tools being demonstrated. Innovative operations and rare procedures that the surgeon has never or only occasionally performed previously should not be broadcast.
       

    7. It is highly encouraged that surgery be broadcast from the surgeon’s home operating room. 
       

    8. When it is not possible to broadcast a live surgery from the surgeon’s home operating room, the operative facility should be configured as closely as possible to the surgeon’s home operating room environment. Only highly experienced operating room staff who are fluent in the surgeon’s preferred language should participate. It is preferable that the surgeon’s own staff assist in the operation in collaboration with local operating room staff and a local surgeon.
       

    9. The local institution and local surgical team should always reserve the right to cancel the operation up to the day of surgery, if it is felt that the procedure is not in the best interest of the patient. 
       

    10. During the recording of a surgical procedure, the surgeon and his or her staff must always ensure that the video crew does not interfere with the progress of the operation.
       

    11. Because discussion with a remote audience during an operation may distract the surgeon, discussions should be one-way, from surgeon to audience. If a two-way discussion is demonstrably essential to educational value, questions and comments from the audience should be controlled; for example, communications should be relayed through a surgeon moderator on the audience side who alone can communicate with the surgeon at times when the circumstances of the operation permit it.  The moderator should never be an industry representative.
       

    12. A moderator on the audience side should be designated for every live surgery broadcast.
       

    13. Live surgery transmissions from the operating room should be terminated at any time that an emergency arises, the safety of the patient could be potentially compromised, and/or the operating surgeon, members of the surgery team, or the moderator on the audience side, become uncomfortable with the progress of the case. 
       

    14. The operating surgeon has a responsibility to ensure satisfaction of the following requirements before each broadcast:
       

      1. The operating facility, if not in the surgeon's home institution, should be suitable for the conduct of the operation to be broadcast;
         

      2. A preoperative conference should be held with the principal parties, including the operating surgeon and key medical and technical (filming) staff, to review the ethical guidelines and safety standards under which the operation will be performed;
         

      3. If the surgery intended for live broadcast is not taking place at the surgeon’s home institution, the operating surgeon should meet with the patient and review all relevant data (imaging, case histories, etc.) on the day prior to the surgery;
         

      4. Transparency of quality and patient-specific outcomes, specifically major adverse events, of the live surgery event should be communicated, protective of all identifying information (per 1.d.), to all participants of the event within 30 days. 
         

  5. Cardiothoracic surgeons should not participate in any capacity in live surgery programs that violate these guidelines.
     

  6. Violation of these guidelines may lead to disciplinary action by the Society.

Amended by the STS Board of Directors: July 1, 2026